Hyperkalemia and acute renal failure are the life-threatening complications of crush
injuries. Vigilant prehospital emergency care is vital to reduce the complications.
We report and discuss 2 cases diagnosed as crush syndrome after earthquake, in order
to illustrate the value of prehospital application of tourniquets to prevent hyperkalemia
accompanying extremity crush injuries. The victim in case 1 died of hyperkalemia shortly
after extrication without tourniquet. The prehospital tourniquet had been used to
avoid uncontrollable hemorrhage and release of toxic metabolites into the circulation
in case 2. Providers need to be fully aware of the risk of hyperkalemia in the field
for patients with crush syndrome. Tourniquet application is strongly recommended in
the prehospital setting for severe crush injuries.
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References
- Crush injuries with impairment of renal function.Br Med J. 1941; 1: 427-432
- Serum potassium in the crush syndrome victims of the Marmara disaster.Clin Nephrol. 2003; 59: 326-333
- Management of crush-related injuries after disasters.N Engl J Med. 2006; 354: 1052-1063
- Crush syndrome: a case report and review of the literature.J Emerg Med. 2014; 46: 313-319
Article Info
Publication History
Published online: January 09, 2014
Accepted:
December 31,
2013
Received:
December 22,
2013
Footnotes
☆The value of prehospital tourniquet application with extremity crush injuries after an earthquake.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
